Abstract P3155: Socio-Demographic Disparities in the Management Modalities of Pulmonary Embolism Amongst COVID-19 Patients: A Retrospective Population-Based Study

Abstract

Introduction: Pulmonary embolism (PE) affects 60 to 70 persons per 100,000 people and causes about 7 million DALYs worldwide, making it an economically onerous handicap condition in the US. COVID-19's hypercoagulation and pro-inflammatory condition increase PE risk (OR 4.4 and RR 3.1) compared to non-COVID-19 individuals. Few studies have examined modalities and disparities in use. Aims: The study's main goal was to calculate the utilization rate and predictors of utilization of PE therapy modalities (tPA/thrombolytics, mechanical thrombectomy [MT], and surgical thrombectomy [ST]), and treatment disparities in COVID-19 patients in the US. Methods: We performed a retrospective cross-sectional observational study of a nationwide inpatient sample (year 2020) in adult hospitalizations with PE to identify patients with COVID-19. ICD-10 codes were used. Using SAS 9.4, we ran a univariate analysis using the chi-square test and multivariate survey logistic regression analysis to calculate adjusted OR and 95% CI. Results: Of 172,630 PE hospitalizations, 3124 patients had COVID-19. PE patients with COVID-19 were younger (mean age 60 vs 66) with the age group of 18-44 (2.54% vs >65-year-old 1.36%), male (1.99% vs female 1.63%), and Hispanics (4.47% vs African Americans 2.71% vs White 1.35%) in comparison to non-COVID-19. PE with COVID-19 had a higher prevalence of obesity (30.72% vs 29.6%) and diabetic mallitus (12.8% vs 9.76%). Utilization of tPA (3.36% vs 3.14%), MT (7.04% vs 5.58%), and ST (0.32% vs 0.19%) were higher amongst PE with COVID-19. tPA use was higher amongst young [OR 1.47 (95%CI 1.01-2.14), females (1.54, 1.17-2.04), and patients with diabetes mellitus (1.73, 1.18-2.53). MT use was higher amongst young (1.46, 1-2.12), African Americans (1.8, 1.45-2.24) and Hispanics (2.99, 2.06-4.35) (compared to White), patients with cardiogenic shock (3.06, 1.91-4.90), ischemic stroke (3.33, 1.55-7.15), diabetes mellitus (1.29, 1.01-1.63), and obesity (2.54, 2.15-3.0). ST use was higher amongst COVID-19 (7.48, 1.94-28.88), males (17.54, 3.5-83.33), patients with AFib (7.49, 1.68-33.49), and obesity (4.75, 1.37-16.51). Conclusion: Management discrepancies among PE patients with COVID-19 include younger age, male, African American, and Hispanic, with ischemic stroke, AFib, obesity, and diabetes using more. To reduce socio-demographic differences in COVID-19 pulmonary embolism care, personalized management techniques, and equitable healthcare resources should be developed.